Criticism of ‘research parasites’ moves NEJM in the wrong direction

By several measures, the New England Journal of Medicine is the top medical journal in the world. The papers it publishes are cited more often, on average, than papers in any other competitor journal, and by a large margin. It’s on the must-read list for physicians in this country and elsewhere, and researchers consider getting an article into the journal a capstone to their careers.

That seemed a bit overwrought, but Drazen walked back from the “parasite” claim Monday, attributing it in a clarifying editorial to “clinical trialists around the world” who “were concerned that data sharing would require them to commit scarce resources with little direct benefit.” Some of those researchers, Drazen wrote, “spoke pejoratively in describing data scientists who analyze the data of others.”

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We were just airing the concerns, Drazen now says. But Drazen didn’t do anything to push back on the “research parasites” claim, which is really unfortunate.

This case reminds us of another in which he and other editors defended the status quo — that is, slow or nonexistent data-sharing — after two leading cardiologists called for more transparency.

That exhortation, from Dr. Eric Topol and Dr. Harlan Krumholz, came in a Sept. 18 New York Times op-ed in response to the National Institutes of Health’s refusal to release all of the data from a key blood pressure study that seems likely to change treatment approaches. “Throughout science we are seeing more rapid modes of communication,” they wrote. “The traditional approach was not to publish until everything was finalized and ready to be chiseled in stone. But these sorts of delays are unnecessary with the Internet.”

Drazen and colleagues disagreed. They were “surprised by the call from Topol and Krumholz for immediately ‘placing the data on the NIH website,’” they wrote in the NEJM. It’s too important, they wrote, “to give the investigators, on behalf of the study participants, who invested years of their lives in the study, the opportunity to see what led the sponsor to stop the trial and then the opportunity to distill a clinical message from it. There are cogent reasons to follow this approach rather than put trial data in the public domain before those who gathered the data have had a chance to analyze it.”

That’s wrong. With the exception of maintaining patient confidentiality — which isn’t the issue here —sharing data shouldn’t come with any strings. Attaching caveats here is a bit like saying: We’re interested in truth, but only in our truth.

And these two cases come on the heels of another widely panned series on conflict of interest in the NEJM that many felt was trying to wind the clock back to a time when we simply ignored ties between industry and clinical medicine. “This is sad,” wrote Roy Poses, president of the Foundation for Integrity and Responsibility in Medicine, “because the journal was once considered the foremost English language scholarly medical journal, but it now seems to be publishing polemics.”

Now, we happen to applaud medical journal editors who crusade instead of just publishing clinical trials. But we’d prefer if they pushed medicine and the public health forward, instead of longing for a more tidy but deeply flawed past.